Test 1-3 Flashcards
T or F - Placenta previa usually occurs in the third trimester and is associated with bright red painful bleeding.
False
T or F - Abruptio placenta usually occurs in the third trimester and is painful with bright red bleeding.
True
Atrial fibrillation treatment algorithm:
If hypotensive begin with bolus of ____ to _____ mL.
What symptoms are considered unstable? (3)
Cardioversion requires what?
You can consider what before cardioverting?
250-1000
Severe shortness of breath, chest pain, or hypotension
Medical control
Versed 1-5 mg IV IM
Regarding AICD patients, in the event of device cardioverting runs of V-tach and patient is conscious, should you externally cardiovert the patient using your pads?
No.
What drug could you administer to the discussed pt whose AICD is cardioverting properly?
Lidocaine 1.5 mg/kg IV
Pt on your monitor shows sinus tachycardia and their AICD is delivering shocks. What is your next action?
Rapid transport
What does a notched waveform represent on waveform capnography?
Pulmonary embolism or paralytic effects
During resuscitation you have a sudden spike in exhaled CO2 (35-45), what does this suggest?
ROSC
Describe treatment for limb presentation delivery.
Place mother in left lateral recumbent and keep exposed parts moist with normal saline dressings. Do not pull on body parts. Transport immediately with mother on high flow O2. Do not deliver in the field.
Describe the treatment for prolapsed cord.
Do not push the cord back in. Administer high flow O2 and begin rapid transport. Using a gloved hand, push the baby’s head away from the cervix and keep pressure off the cord (maintain a pulsatile cord). This may be helped with the mother in knee to chest position. Keep exposed cord moist with normal saline.
T or F - All taser victims require transport to the hospital?
False
In the event the barbed end of a taser dart remains in a puncture site, what would be your next course of action?
Make sure the cartridge has been disconnected and the taser is not applying charge.
Cut the wire 6-8 inches from each dart.
Wearing latex gloves, firmly grasp the dart probe between the thumb and index finger of one hand. Use other hand to stabilize skin surrounding the probe site.
Remove the dart with a hard jerk.
Examine the barb tip to ensure that it is fully intact.
T or F - Traction splints may be applied on both closed and open mid femur fractures.
False
Occasionally you will have a competent individual with unstable vital signs that needs to go to the hospital but is refusing, if this should occur you must contact whom for guidance and in concert with what other public safety entity?
Medical control and PD
In stable V-Tach(with a pulse) you have administered a total of 3m/kg of Lidocaine with no change, what is your next option?
Lidocaine drip at 1-4 mg/min IV. monitor for signs of lidocaine toxicity.
You have an adult male in Asystole, after confirming in two contiguous leads you begin CPR, set up for an intubation while someone else is acquiring IV/IO access, provide the next two steps that need to follow in this algorithm?
Epinephrine 1:10000 1 mg IVP
Transthoracic Cardiac Pacing
What is a contraindication for administering lidocaine?
A wide complex rhythm < 80 bpm. It may be an accelerated junctional rhythm.
In Post-Resuscitation scenario, the patient has had a ROSC for >5min but the blood pressure is still persistently below
IV fluid normal saline bolus 250-1000 mL IV
Dopamine drip 10-20 mcg/kg/min titrated to BP>100mmHg
You have a renal patient at home in Polymorphic V-Tach(Torsades de Pointes) with a pulse, what are your options?
Magnesium sulfate 2gm IV over 2 minutes before lidocaine
Patients experiencing PVC’s at greater than what per minute are candidates for pharmacological intervention and what is the minimum heart rate that must be present before administering that medication according to our protocol?
> 10 PVC’s per minute with heart rate of > 80 BPM before administering lidocaine
T or F- 2nd and 3rd degree heart blocks are not a consideration when trying to eliminate PVC’s.
False
In a suspected hyperkalemia patient (ESRD/Renal failure) that is in V-Tach with a pulse, you provide what medications? List them all.
- Sodium bicarbonate 1 amp (50 mEq)
- Calcium gluconate 1 gm IV
- A second sodium bicarbonate 1 amp (50 mEq)
Thoroughly flush between medications or use 2 lines
What intervention occurs before the administration of Epinephrine in adult PEA?
IV access with 1000 mL fluid bolus
List at least 3 of the exclusion criteria for Therapeutic Hypothermia induction.
Active bleeding or coagulopathy Purposeful response to verbal commands or noxious stimuli Recent major surgery Traumatic arrest Pregnant 16 years of age or younger Terminal illness or DNR pt Downtime > 30 minutes
What are the drugs given in an allergic reaction?
Diphenhydramine 25-50mg IV or IM
Albuterol 5 mg neb
Methylprednisolone 125 mg IV or IM
Epinephrine 1:1000 IM 0.3 mg
Epinephrine 1:10000 0.5 mg-1 mg IV over 2 minutes in cases unresponsive to IM epinephrine
Dopamine 10-20 mcg/kg/min IV as ordered by medical control for persistent hypotension
Concerning “Obvious signs of Death”, what are they?
Dependent lividity - venous pooling of blood in gravity dependent areas occurring 1-2 hours after death, peaking at 6 hours
Rigor Mortis
Gross decomposition
Dead mouth
What meds are given in a cardiac arrest patient with a PMH of renal failure?
Calcium gluconate 1 gm IV followed by
Sodium bicarbonate 1 amp IV after thoroughly flushing the line.
Can Glucagon be given in pediatrics and if so at what dose?
0.5 mg IM in children older than 4
What two other instances is Glucagon indicated (other than Hypoglycemia) and at what dose?
Calcium channel and beta blocker overdose
3-5 mg IV
Dopamine can only be administered until after you have contacted Medical Control (True or False)?
Tries
In a hypotensive (b/p <100 mmHg) ROSC patient, what should be done prior to considering a Dopamine drip?
Fluid bolus
In a pulseless V-Tach or V-Fib post-resuscitation, what drug should be bolused and a maintenance drip started(hint), also what is the minimum Heart rate the patient must possess?
Lidocaine with heart rate of >80 bpm
Bolus dose of 1.5 mg/kg IV if not already administered and a drip rate of 1-4 mg/min.
What are the contra-indications for Labetalol?
Severe CHF Severe asthma 2nd degree type 2 or 3rd degree heart block HR < 70 Allergy to beta blockers
What is the criteria for administering Labetalol?
Either a systolic BP > 220 mmHg or diastolic BP > 110 mmHg, and severe chest pain, severe headache, or altered mental status
